Finally, the mode of onset of labour deserves special consideration in patients with unstable lie, malpresentation, or polyhydramnios. In these circumstances there is much to commend elective amniotomy in a controlled fashion in an operating theatre rather than for the obstetrician to wait for spontaneous rupture of the membranes. If the cord is going to prolapse it is preferable that it should do so while the operator's fingers are still within the vagina. This approach also permits him to

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... y a monitoring electrode at the earliest possible moment.